In our previous paper on the Future of Cognitive Remediation published more than 10 years ago, we envisaged an imminent and wide implementation of cognitive remediation therapies into mental health services. This optimism was misplaced. Despite evidence of the benefits, costs, and savings of this intervention, access is still sparse. The therapy has made its way into some treatment guidance, but these documents weight the same evidence very differently, causing confusion, and do not consider barriers to implementation. This paper revisits our previous agenda and describes how some challenges were overcome but some remain. The scientific community, with its commitment to Open Science, has produced promising sets of empirical data to explore the mechanisms of treatment action. This same community needs to understand the specific and nonspecific effects of cognitive remediation if we are to provide a formulation-based approach that can be widely implemented. In the last 10 years we have learned that cognitive remediation is not “brain training” but is a holistic therapy that involves an active therapist providing motivation support, and who helps to mitigate the impact of cognitive difficulties through metacognition to develop awareness of cognitive approaches to problems. We conclude that, of course, more research is needed but, in addition and perhaps more importantly at this stage, we need more public and health professionals’ understanding of the benefits of this therapy to inform and include this approach as part of treatment regimens.

中文翻译：

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重新思考认知矫正疗法的未来：在患者获得治疗之前还需要解决哪些问题？


在我们十多年前发表的关于认知矫正的未来的论文中，我们设想认知矫正疗法即将在心理健康服务中广泛实施。这种乐观情绪是错误的。尽管有证据表明这种干预措施的好处、成本和节省，但获得的机会仍然很少。该疗法已进入一些治疗指南，但这些文件对相同证据的权重差异很大，导致混乱，并且没有考虑实施的障碍。本文回顾了我们之前的议程，并描述了如何克服一些挑战，但仍然存在一些挑战。科学界致力于开放科学，已经产生了一组有希望的经验数据来探索治疗作用的机制。如果我们要提供一种可以广泛实施的基于公式化的方法，那么这个社区就需要了解认知矫正的特定和非特定效果。在过去的十年中，我们了解到认知矫正不是“大脑训练”，而是一种整体疗法，其中包括积极的治疗师提供动机支持，并通过元认知帮助减轻认知困难的影响，以培养对认知方法的认识问题。我们的结论是，当然需要更多的研究，但除此之外，也许在现阶段更重要的是，我们需要更多的公众和卫生专业人员了解这种疗法的好处，以告知这种方法并将其纳入治疗方案的一部分。